A single-stitch technique on the internal carotid artery for establishing the MCAO model

Stroke is a leading cause of death and disability worldwide. Traditional cerebral ischemia-reperfusion models involve ligating the external carotid artery (ECA) to embolize the middle cerebral artery (MCA), often leading to complications such as impaired blood flow to facial and cervical regions, difficulty swallowing, and reduced survival rates. These limitations hinder accurate replication of human ischemic stroke mechanisms and long-term therapeutic evaluations.

This study introduces an modified single-stitch middle cerebral artery occlusion (MCAO) technique. It involves a small incision in the internal carotid artery (ICA) to directly block the MCA, preserving the ECA and avoiding its ligation. This approach minimizes potential complications and better aligns the model with human stroke pathophysiology.

The assessment of behavior, pathology and physiology proved the effectiveness of this method. The ICA group showed no effect on facial and cervical blood flow, and there was no difference in neurological deficit score and TTC staining infarction volume of brain slices between the ICA group and the ECA group. Furthermore, the ICA group recovered better in terms of weight and survival rate within 30 days, and had higher levels of thyroid hormones. In contrast, in the ECA group, after HE staining, the follicular structure of the thyroid gland was significantly damaged and the thyroid hormone level was lower.

the single-stitch method demonstrated potential advantages in our study, including trends toward reduced complications and improved survival, potentially leading to more reliable drug screening outcomes due to its improved pathophysiological relevance.

The single-stitch MCAO technique presented here represents a refined approach that, in this preliminary study, was associated with fewer complications and greater translational relevance.